MedicalResearch.com Interview with:
Dr. Amit J. Shah MD MSCR
Research Assistant Professor
Assistant Professor of Epidemiology
Rollins School of Public Health
Adjunct appointment in Medicine (Cardiology)
Atlanta VA Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Nearly ½ of sudden cardiac deaths occur in individuals who were not aware that they had heart disease; this increases the need for primary prevention. We studied whether the electrocardiogram could be a useful tool in helping to measure risk of cardiovascular disease in approximately 10,000 community-based adults aged 40-74 with a simple risk equation that is based on age, sex, and 3 numbers from the ECG: heart rate, T-axis, and QT interval. We found that such an equation estimates risk as well as the Framingham risk equation, which is the standard of care (based on traditional risk factors like smoking and diabetes). When combining both the Framingham and ECG risk assessments together, the accuracy improved significantly, with a net 25% improvement in the risk classification of cardiovascular death compared to using the Framingham equation alone.
MedicalResearch.com: What should readers take away from your report?
Response: The ECG is normally used to diagnose active or present-day heart disease in select individuals thought to be at risk. Many asymptomatic patients with normal ECG’s, however, may have electrocardiographic signs of disease that could predict future risk. This may suggest the ECG as an important screening test for adults looking to prevent heart disease. Although more research is needed to confirm its clinical utility as a screening test, this study is an important step forward in helping to understand its potential, and the need for more research.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We need to do a clinical trial in which asymptomatic patients undergo ECG screening, and their treatment is potentially modified based on the ECG score results. This may mean that some patients undergo more aggressive lifestyle change, or start new medications for blood pressure or cholesterol, for example. Some patients may also be reassured based on their ECG score, which may provide some form of positive reinforcement.
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